Posts tagged “elderly”

Rethinking Everything About What You Do For Customers


Rebecca Mead’s New Yorker feature The Sense of an Ending describes some really dramatic (and successful) reframes in care for dementia patients. There’s a number of profound shifts in how the caregivers describe their role and in the kind of experience they seek to deliver for the patient (and their family). The whole article (linked above, but subscribers only) describes those shifts and the cultural and organizational efforts to get there. I’ve included just a portion here

One of the first things Alonzo did, in 1998, was to ask an aide who was born in Vietnam to talk to staff members in her native tongue. “It was the only language I could find that nobody else could speak,” Alonzo recalled. “So we had her tell us very sweetly, in Vietnamese, what she wanted us to do, and we couldn’t understand her.” The staff had to become attuned to the woman’s nonverbal cues.

On another occasion, Alzono underwent a public bed bath, in front of the entire staff, of twenty-seven. She didn’t allow herself to move her limbs, and behaved as if confused. Afterward, she was able to describe the nature of her discomfort, and staff members analyzed their own activity in light of it. “Let me tell you, it sucked – it was incredibly uncomfortable,” she told me. Staff members then spooned food into one another’s mouths and brushed one another’s teeth, in order to be on the receiving end of activities that they performed for their charges every day. “You can find how threatening it is to have something touch your mouth when you have not brought it to your own lips,” she said.

In the most radical experiment, the staff wore adult diapers. “That was kind of life-changing for everybody involved,” Alonzo told me. “We all recognized just how uncomfortable it was to sit in a wet brief. Some of our front-line staff, who really wanted to know how bad that felt, did not change them for a couple of hours.” Previous may residents had been dressed in diapers, as they tend to be in a majority of nursing homes. Not long afterward, aides decided to stop the practice with most residents, instead taking them to the bathroom fifteen or twenty minutes after mealtimes. This made residents happier while making the staff’s jobs easier, because they no longer had to change people who were agitated.

There’s a rich tradition of participating in the experience our customers are having (see this great war story about an adventure in an “old age simulation suit”) and what feels like an increasing mention of empathy. I really like how this story highlights not so much the ergonomic or functional task aspects that are revealed but how this drives to revisiting the fundamental ideas of how the institution conceives of the patient experience it provides. I also like the full-on simplicity of the approach, the people who do this stuff to others now try it themselves and talk about it.

See also Richard Anderson’s blog post from this week about reframes in general and in healthcare specifically.

David’s War Story: Suit yourselves

David Serrault is an Information Architect and Experience Designer for SNCF, in France.

It took a long time and several discussions with the stakeholders from SNCF (the French railways operator) to receive authorisation for a field investigation using old-age simulation suits. We were to focus on Gare Du Nord, the largest railway station in Europe. The station hosts more than 190 million passengers a year, including commuters, long distance travelers from all across Europe, businessmen and tourists from anywhere in the world. Gare Du Nord is filled with people in movement, following their daily routine or finding their way in this complex ecosystem of platforms, corridors and stairs, all managed by several operators.

I have always been fascinated by railway stations. Even more than the airport, I think that they are like temples of modernity, ruled by time and noisy, heavy, industrial technology.

The goal of this onsite experiment was to evaluate the gaps in the information provided to travelers, especially older ones. The old-age simulation suit makes the user feel the constraints of an elderly person. The suit, made in Japan, looks like a kind of kimono such as one might wear for practicing judo. But this one is green and red, covered with belts and weights in order to simulate the physical constraints of an old person. Also, you have to wear glasses to restrict your visual field and reduce your ability to perceive contrasts as well as ear plugs to reduce your hearing.

We were four: my friend and colleague Christophe Tallec (a French service designer) and two students. We set out in the morning for our day of experimentation. Indeed we were a bit worried by working in such a crowded public space. Even with an official authorisation from the station officer it was difficult to imagine what the reaction of the police authority and the users of the station would be. The place had been a scene of a spontaneous riot a few months before, when a young boy from a low wage suburb commonly called “Banlieusard” had been arrested and assaulted by the police.

The main difficulty we faced was more a logistical one. Each of us was to attempt a pre-defined journey through the railway station but we had to find a place to put on the suit. Eventually we did this behind some ticket vending machines that were close to the bus station. Not a very intimate place, but good enough!

Surprisingly the police simply came to ask us what we where doing and then let us do our job. We didn’t encounter special reactions from the passengers who seemed to deliberately ignore us.

This experiment was a revelation, especially for the youngest members of the team. We realised how many constraints someone with physical limitations can face during journey through a public space like this one. These spaces are dedicated to people flow, but disabled or challenged individuals are like aliens. There are many initiatives to make these areas accessible and readable but how can this be a priority for an organisation that has to manage daily security and transit efficiency for millions of people. It is a huge challenge for the designers and the architects who work for these places.

Eventually we realised that indeed a few passengers were staring at us, especially ones who were dressed as Sailor Moon, Naruto or other manga and video game heroes. The day of our research was also one of the largest conventions for Japanese culture aficionados in Paris. Japan Expo is known for its concentration of “cosplay” practitioners; many these young adults were simply in their costume to the event by public transit.

From their side, I suppose they were wondering what kind of manga persona we were playing. From my side, I felt like I was at the meeting point between modern and post-modern times.

ChittahChattah Quickies

  • [from steve_portigal] Drilling Down – Why Elite Shoppers Eschew Logos [] – Rather than rely on obvious logos, expensive products use more discreet markers, such as distinctive design or detailing. High-end consumers prefer markers of status that are not decipherable by the mainstream. These signal group identity only to others with the connoisseurship to recognize their insider standing. In one study, fashion students were more likely than regular students to favor subtle signals for products visible to others, like handbags. But for private products less relevant to identity, like underwear and socks, there was no difference between the groups. Jonah Berger, an assistant professor of marketing at the University of Pennsylvania and one of the paper’s authors, said it was not that insiders simply had a dislike for logos. Instead, he said, they avoid them “in identity-relevant domains to distinguish themselves from mainstream consumers who buy such products to show they’ve made it.”
  • [from steve_portigal] | News and Reviews of Products with Elder Friendly Features – Those of us with aging parents share many things, chief among them the desire that our elderly loved ones have the opportunity for the same quality of life that we enjoy. For some this means remaining independent, for others it might mean a need to make caregiving simpler to meet the needs of people we love. The elderly prefer simple uncomplicated gadgets and products which are lighter and specially designed with higher contrast, pre-programmed features. Products of use might include talking Pill boxes, medi-alerts, and a myriad of gadgets with simple “how to use” instructions. That’s the focus with Eldergadget, a comprehensive blog where a person with an aging loved one can go to find the latest gadgets that meet a seniors needs and maybe some products you have never dreamed possible. We also bring you the latest up to date news, videos and developments in technology for seniors. We also include lighthearted fare such as humor and retro gadgets in order to brighten a person’s day.

FreshMeat #6: Take Pictures, Last Longer!

FreshMeat #6 from Steve Portigal

               (oo) Fresh                  
                \\/  Meat

Serendipitous discovery of the customers marketing forgot

Over the past few months I have been attending a local
photo club, held in a small room in the City Hall of a
small Bay Area town. The group gathers about once a week
to share techniques and images.

I am by far the youngest member of the club. I would
put the next youngest person at about 20 years older
than I, and I’d put the average age at 30 years older.

This has made the whole experience interesting, and
very useful. My fellow club members not only have photos
that are 50 years old, they have 50 years of expertise
in taking photos. In a recent meeting, the discussion of
archival materials took on an interesting slant as each
of several men in their seventies dismissed the whole
notion with great bemusement. “Archival materials? But
I’m already archival!” joked one.

The pacing of the meetings is very gentle, and at
first I found that jarring, but I’m learning to ride
with it. As a newcomer to the club, I’ve had the chance
to do a microethnography of the meetings, and I’m going to
share a few of my findings here.

The club provides value to its members by providing a
forum for sharing consumer information: what products
to use (say, for mounting a print), where to find them
for a good price, and so on. A typical exchange might run
something like this (all names have been changed):

Bob: …so now you take the edge cutter here…
Gene: Say, Bob, where do you find a cutter like that?
Bob: What, now?
Gene: I was asking about the cutter.
Marion: Gene is asking about your cutter, Bob.
Bob: Oh, the cutter.
Hugh: You can pick ’em up at any photo store.
Bob: I ordered this one online.
Hugh: Or you can order ’em online.
Bob: Or you can get one at that store down towards…
Bob: Oh, I guess down near Belmont. What’s the place?
Gene: The place near the Safeway?
Bob: No, it’s by the store, there…
Marion: By the Safeway?
Bob: I say what, now?
Doug: By the Safeway?
Marion: By the Safeway?
Bob: …No, it’s down near Belmont.
Gene: Photo Paradise?
Marion: The Precious Frame?
Bob: No…down near Belmont, there, where Hap got his
press last month…
David: Oh, Linda’s place. The Darkened Room.
Bob: I say what, now?
Bob: That’s it. Down by Belmont, The Darkened Room.

Okay, I’m exaggerating, but not that much. But beyond my
gentle mocking is a great example of a social network
exchanging consumer information.

I am also fascinated by the level of computer knowledge
many of the individuals possess. There’s not a lot of web
surfing, or email usage. Club admin info is shared by
telephone, by snail mail, or by handing out photocopied
sheets at meetings. In fact, there is no way any of these
folks are going to be buying a digital camera. But the
computer is a tremendously important tool when it supports
and extends their existing photographic behaviors, namely
scanning and printing of images. Several club members have
invested a great deal of money in color printers, paper,
and ink. And remember, these are not the “grandmas” that
marketeers drool over, the one that will invest in anything
that might provide better connections to children and
grandchildren — these are photographers and artists. They
are wrestling with the technology to make it serve their

One woman came in and presented the results of a
benchmarking study she had done to get the truest black and
white image output. She built a matrix that varied the
paper (manufacturer, grade, matte/glossy), the printer,
the image source (slide, print, color, black & white), and
some software settings that affected the type of printing
being done (I think it was black ink or color ink). (Side
note: if you think the discussion about the store location
was crazy, you should have heard the discussion of how to
change the printing settings in Photoshop…) For each
cell in her matrix, she had a different printout, and we
could see the green shift, the blue shift, and so on. It
was quite excellent.

I’m not suggesting this is a huge market — my evidence is
purely anecdotal. It may not be cost-effective for the
manufacturers to better understand these customers, to
develop and market products especially for them. I don’t
know. But what is provocative is how easy it is for anyone
to stumble on a market that is clearly not well understood,
that absolutely flattens the beliefs about others that
marketers have foisted upon us, for better or worse.


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